title: Paediatric patients with abusive head trauma treated in US Emergency Departments, 2006-2009.
abstract: OBJECTIVE
  To study characteristics and outcomes of paediatric patients with abusive head trauma (AHT) treated in emergency departments.
  
  
  METHODS
  Nationwide Emergency Department Sample (NEDS) data were analysed. The CDC recommended AHT definition was used to classify children ≤ 4 years with head trauma into AHT and non-AHT groups. Outcomes were compared between patients with AHT and patients with non-AHT. Logistic models were fitted to identify risk factors.
  
  
  RESULTS
  An estimated 10 773 paediatric patients with AHT were treated in EDs in 2006-2009. The average annual rate was 12.83 per 100 000 for children ≤ 4 years. Children < 1 year of age accounted for most AHT cases (60.6%) and males had a significantly higher AHT rate than females. Medicaid was the primary payer for 66.1% of AHT injuries and 40.3% of non-AHT injuries. The case mortality rate was 53.9 (95% CI = 41.0-66.7) per 1000 patients with AHT compared with 1.6 (95% CI = 1.4-1.9) per 1000 patients with non-AHT.
  
  
  CONCLUSIONS
  Child caregivers should be educated about the serious consequences of AHT and proper techniques for caring for infants. Unbiased and accurate documentation of AHT by physicians and medical coders is crucial for monitoring AHT injuries.
authors.affiliation: Center for Injury Research and Policy, The Research Institute at Nationwide Children's Hospital , Columbus, OH , USA .
authors.forename: Joe
authors.initials: J
authors.lastname: Xiang
authors.forename: Junxin
authors.initials: J
authors.lastname: Shi
authors.forename: Krista Kurz
authors.initials: KK
authors.lastname: Wheeler
authors.forename: Keith Owen
authors.initials: KO
authors.lastname: Yeates
authors.forename: H Gerry
authors.initials: HG
authors.lastname: Taylor
authors.forename: Gary A
authors.initials: GA
authors.lastname: Smith
mesh_terms: D017028:Caregivers / Q000193:education / Q000331:legislation & jurisprudence; D002648:Child; D002649:Child Abuse / Q000175:diagnosis* / Q000331:legislation & jurisprudence / Q000517:prevention & control; D002669:Child Welfare; D002675:Child, Preschool; D004636:Emergency Service, Hospital; D005260:Female; D019983:Guideline Adherence; D017408:Guidelines as Topic; D016489:Head Injuries, Closed / Q000175:diagnosis* / Q000517:prevention & control; D006801:Humans; D015994:Incidence; D007223:Infant; D007231:Infant, Newborn; D038801:International Classification of Diseases; D016015:Logistic Models; D008297:Male; D016017:Odds Ratio; D012307:Risk Factors; D014481:United States